Senate Committee Looks at Boosting Vaccination Rates
With measles in Washington state and mumps in Pennsylvania, it seems like vaccine-preventable diseases are staging a 2019 comeback. In early March of 2019, I attended the Senate Committee on Health, Education, Labor and Pensions (HELP) hearing titled “Vaccines Save Lives: What Is Driving Preventable Disease Outbreaks?”. While the House Committee on Energy and Commerce’s similar hearing just a few days earlier garnered minimal interest, there was already a line snaking around the corner by the time I arrived a good 90 minutes before the hearing started.
ASM strongly supports the universal use of vaccines. As an ASM employee, a trained microbiologist and the mother of 2 small children, I was dismayed to discover that most people in line belonged to anti-vaccination organizations. Those of us without slogan T-shirts stood awkwardly next to them, trying to avoid confrontation and eavesdropping on conversations filled with false claims.
The anti-vaccination movement has been around since vaccines themselves, but gained significant traction from the now-discredited work of Andrew Wakefield linking autism and vaccines. Despite additional studies finding no such evidence, as well as the discovery that Wakefield falsified his data, anti-vaccination groups remain convinced that vaccines do more harm than good (to be clear: very rarely, vaccines can cause injury). To avoid stigma, these organizations have rebranded, disguising their opposition as a matter of informed consent, parental rights or religious freedom.
The Purpose of the Hearing and the Players Involved
Senators were seeking input on how the federal government can support higher vaccination rates in the United States, particularly in those communities that have dropped dangerously below the rates needed to sustain herd or community immunity.
The committee heard from 5 witnesses with diverse backgrounds in public health, academia and teenage rebellion:
- John Wiesman, Dr.P.H., M.P.H., who at the time was Washington state's Secretary of Health and top public health official.
- Saad Omer, M.B.B.S., M.P.H., Ph.D., a professor of global health, epidemiology and pediatrics from Emory University.
- Jonathon McCullers, M.D., a pediatrician from Le Bonheur Children’s Hospital and the University of Tennessee Health Science Center.
- John Boyle, President and CEO of the Immune Deficiency Foundation, a patient advocacy organization for individuals with primary immunodeficiency diseases.
- Ethan Lindenberger, a high school student who got himself vaccinated against his parent’s wishes.
The hearing was held under the assumption that current outbreaks are the result of waning vaccination rates and that these rates have dropped because of aggressive misinformation campaigns from anti-vaccination groups. Dr. Omer supported these assumptions in his testimony, stating that “more than half of the [measles] cases since elimination [in the U.S.] have been unvaccinated and approximately 70% of them are unvaccinated due to vaccine refusal or non-medical exemptions.” Anecdotally, Mr. Lindenberger’s story also supported these assumptions. He pointed to misinformation on social media as the source of his mother’s anti-vaccination views.
Recommendations from the Witnesses
Witnesses proposed several ideas for how the federal government could influence vaccination rates and thereby lower the number and impact of vaccine-preventable disease outbreaks in the future.
- Dr. Wiesman argued for a 22% increase in the CDC’s budget by 2022, including the creation of a coordinated, national campaign headed by the CDC to fight vaccine misinformation.
- Dr. Wiesman urged the reauthorization of the Pandemic and All-Hazards Preparedness Act (PAHPA) as well. ASM supports PAHPA reauthorization as a critical mechanism for state and federal outbreak response.
- Vaccine exemption requirements are currently the purview of states. Dr. Wiesman argued for making exemptions from vaccination as hard to obtain as the vaccinations themselves.
- Dr. Omer stressed the need to fund vaccine communication research to strengthen the evidence base for what works in fighting vaccine hesitancy.
- Currently, there aren’t many incentives for doctors to take the time to talk through a patient’s concerns about vaccines, which current research shows is one of the most effective measures against vaccine hesitancy. Dr. Omer suggested making vaccine counseling, where a doctor spends dedicated time talking through any concerns parents or patients might have, an insurance-reimbursable service.
The current outbreaks of vaccine-preventable diseases are just the most recent in a long line over the last 2 decades. In fact, Senator Tammy Baldwin (D-WI) remarked on how disheartening it was to hear again some of the same things she heard in 2015 hearings. It will be interesting to see what, if any, action Congress takes. Dr. Wiesman mentioned several times that the burden for both encouraging vaccination and containing these preventable outbreaks falls primarily on states, whose health departments are notoriously under-resourced. The question is whether the landscape has shifted enough for states to get the federal backup they need.
In the meantime, there is a lot you and I can do to support vaccination. Find out about your state’s vaccine exemption laws and any pending legislation to change them, and contact your state legislators. If someone you know expresses vaccine hesitancy, listen to their concerns and point them to reputable sources of information. Be sure to look for more from ASM’s Public and Scientific Affairs Committee on how you can get involved, including a symposium at ASM Microbe on participating in our advocacy efforts.
ASM strongly supports the universal use of vaccines and stands ready to assist Members of Congress in supporting basic and clinical research and promoting evidence-based policies that support immunization regimens recommended by the nation’s public health agencies. Read ASM’s full statements on the recent hearings: